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Primary laparoscopic endorectal pull-through for Hirschsprung's disease in infants and children
1Department of Surgery, University of Alabama School of Medicine and The Children's Hospital of Alabama, Birmingham, AL 35233, USA.
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Laparoscopic primary pull-through surgery for Hirschsprung
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Hirschsprung's disease classically treated with multi-stage pull-through procedures.
- Open primary pull-through offers benefits like shorter hospital stays and avoided colostomy.
- Minimally invasive techniques are increasingly explored for pediatric surgical conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of laparoscopic primary endorectal pull-through for Hirschsprung's disease.
- To compare outcomes with traditional open or multi-stage approaches.
Main Methods:
- A consecutive series of 24 pediatric patients underwent laparoscopic primary endorectal pull-through.
- Patient age ranged from neonates to 6 years.
- Surgical techniques and perioperative outcomes were documented.
Main Results:
- Operative times ranged from 1.5 to 3.5 hours.
- Perioperative complications were minor.
- No patients experienced post-operative enterocolitis or anastomotic strictures; average hospital stay was 3.5 days.
Conclusions:
- Laparoscopic primary endorectal pull-through is a safe and effective surgical option for Hirschsprung's disease.
- This minimally invasive approach offers advantages over open and multi-stage procedures.
- It facilitates earlier intestinal continuity and avoids the need for colostomy.
Abstract:
Colon pull-through for Hirschsprung's disease has classically been performed in multiple stages. Open primary pull-through procedures offer the advantages of shorter overall hospital stay, decreased morbidity, and earlier intestinal continuity, and colostomy is avoided. This article describes the techniques used and results obtained in 24 consecutive patients who had a laparoscopic primary endorectal pull-through for Hirschsprung's disease. The patients ranged in age from a few days to 6 years. Operative times ranged from 1-(1/2) hours to 3-(1/2) hours. Perioperative complications were relatively minor. None of the patients had clinical enterocolitis after primary laparoscopic pull-through, and there were no anastomotic strictures. Average postoperative length of stay was 3-(1/2) days. Primary laparoscopic endorectal pull-through is a safe and effective alternative to open primary or multistage pull-through procedures.